PB2015: DIAGNOSIS, CLASSIFICATION AND STRATIFICATION OF MYELODYSPLASTIC SYNDROMES IN ALGERIA
Authors: Yamina Bouchakour Moussa, Souad Taoussi, Abad Mohand Tayeb, Bradai Mohamed, Sabrina Akhrouf, Ahmed Nacer Redhouane, Rose Marie Hamladji, Nassima Boulaziz, Hocine Ait Ali, Allouda Malika, Brahim Benzineb, Naima Mesli, Benlazar Sidi Mohamed El Amine, Zahia Zouaoui, Farida Kherbache, Hamdi Selma, Hakim Hamouda, Malika Djillali, Djouadi Khadidja, Laid Touati, Lakhdari Nordine, Mhalhal Nemra, Baghdad Samir, Salah Eddine Belakehal
Journal: HemaSphere (2023)

Topic: 10. Myelodysplastic syndromes - Clinical Background: The diagnosis of myelodysplastic syndromes (MDS) is based on cytological and cytogenetic data Aims: Our objective is the application of WHO recommendations for the diagnosis of MDS in order to improve their therapeutic management Methods: This is a retrospective study of 638 MDS from 10 haematology departments. We analysed the haemogram, cytology, karyotype and FISH targeting 5q, 7q, 20q,17p13(P53); 575 met the WHO recommendations for diagnosis Results: This is about 268 M/307W;sex ratio 0.87;median age= 66 years;Hg: 8< Hb <10g/dl =27.3%,Hb ≤ 8g/dl=51%,Macrocytic =30.7%;neutropenia ≤800/µl =18%, thrombocytopenia < 50000/µl = 23.3%,50000/µl ≤ plaq <100000/µl =21.2%;thrombocytosis =2.6%;bicytopenia =30.4%;pancytopenia =25.5%;Blood smear: macrocytosis =73.7%,pseudopelgers=25.2%,hypogranulated=46%, macrothrombocytes =48.5%;blasts< 5% =93.3% ≥5 < 20% = 6.7%,Myelogram: dysemegacarypoiesis= 47.4%,dysgranulopoiesis =53%, dyserythropoiesis =89.3%,multilineage dysplasia=43.4%;bone marrow blasts,> 2< 5% =13.7%,≥ 5% ≤10% =16.6%,< 20% ˃10% =11%,Sideroblastic ring in crown >15% =19.6%,BOM done =17.7%,. CMF done in 4.8%.Cytogenetics:185karyotypes done(32%),normal in 62%,pathological in 38%. FISH done in 141pts,karyotype coupled with FISH were pathological in 65/185 pts(35%):one abnormality in 49,2%,two abnormalities in17%,complex to 3 in 9,2% and ˃3 in 24,6%: del (5q)/-5 in 46%,isolated in 21.5%,del 7q/-7 in 16.9%;del 17p13(p53) in7.6%,tri 8 in13.8%,del 20q in 13.8%,del11q in7.6%,duplications in 9.2%,monosomies in 24.6%,translocations in17%,and other anomalies in 20%. WHO/RA =24%,RN= 0.86%,RT=3.3%,RCDML= 29.2%,RCUDS =8.8%,RCMDSI =2.2%,RAEB1=14%,RAEB2=5%,MDS-i =2 pts, Sd 5q- = 13/185pts (7%);Cytogenetics: very good =1.2%,good =76.3%,intermediate =8.4%,poor= 6.6%,very poor=7.2%;IPSS score on165pts: Low =32%,Intermediate1=47.2%,Intermediate 2=15.7%,High =4.8%;IPSS-R: Very Low =5.4%,Low= 36.3%,Intermediate =32%,High =10.3%,Very High =15.7%.WPSS:very low =24.2%,low=24.8%,intermediate =17%;high =26%;very high =7.8%.Become:277 died (48%),38.2% by transformation,14.4% by comorbidities,83.7% of the high risk,31.8% of the low and 45.2% of the intermediate;298 are alive (52%),median OS and PFS of 39 months,96 months for the low,34months for the intermediate,13.6months for the high and the very high Summary/Conclusion: The diagnostic recommendations were applied in all the patients of the study on the cytological level and only in 32% on the cytogenetic level, the frequency of cytogenetic abnormalities found was 35%, we classified the100% on the cytology which was decisive, the survival was influenced by the type of MDS, the number of cytopenias, by unfavourable cytogenetics, the high prognostic risks of which 88% death. Hence, the interest in developing the missing tools for the diagnosis of MDS in order to improve therapeutic management in the future Keywords: Cytogenetic abnormalities, Myelodysplastic syndrome, WHO classification